Voice of Postradiotherapy Nasopharyngeal Carcinoma Patients: Evidence of Vocal Tract Effect

Lin, Emily; Hwang, Tzer-Zen; Hornibrook, Jeremy; Ormond, Tika

doi:10.1016/j.jvoice.2006.09.011

Cited by 8 publications

(12 citation statements)

References 34 publications

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“…Electroglottographic (EGG) analyses of voice have revealed superior voice outcomes after primary chemoradiotherapy compared with patients with total laryngectomy and transesophageal puncture (TEP), with improvement over a 12-month period in the chemoradiotherapy group [54•]. In postradiotherapy nasopharyngeal cancer patients, EGG analysis of vocal fold vibratory behavior revealed higher speech quotient, a ratio of glottic opening time to closing time, and lower open quotient, an indication of longer closed phase relative to open phase in the cycle in these patients as compared with healthy controls [58]. Both of these measures reflect increased vocal tension or resistance [58].…”

Section: Voice After Primary Chemoradiotherapy: Instrumental and Percmentioning

confidence: 99%

“…In postradiotherapy nasopharyngeal cancer patients, EGG analysis of vocal fold vibratory behavior revealed higher speech quotient, a ratio of glottic opening time to closing time, and lower open quotient, an indication of longer closed phase relative to open phase in the cycle in these patients as compared with healthy controls [58]. Both of these measures reflect increased vocal tension or resistance [58]. These authors also found lower signal-to-noise ratios, indicative of voice abnormality [58].…”

Section: Voice After Primary Chemoradiotherapy: Instrumental and Percmentioning

confidence: 99%

“…Both of these measures reflect increased vocal tension or resistance [58]. These authors also found lower signal-to-noise ratios, indicative of voice abnormality [58]. Others have found abnormal perturbation scores and abnormal perceptual ratings in patients treated with radio/chemoradiotherapy to the larynx [23,53••,55,57••].…”

Section: Voice After Primary Chemoradiotherapy: Instrumental and Percmentioning

confidence: 99%

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Effects of chemoradiotherapy on voice and swallowing

Lazarus

2009

Current Opinion in Otolaryngology & Head and Neck Surgery

112

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Purpose of review-Chemotherapy has been found to result in comparable survival rates to surgery for head and neck cancer. However, toxicity can often be worse after chemoradiotherapy, with impairment in voice, swallowing, nutrition, and quality of life. Investigators are attempting to modify radiotherapy treatment regimens to spare organs that have an impact on swallowing. This review will highlight voice and swallowing impairment seen after chemoradiotherapy, as well as treatment for voice and swallowing disorders in this population. Results of newer radiotherapy regimens will also be highlighted.Recent findings-Specific oropharyngeal swallowing motility disorders after chemoradiotherapy have been identified. Damage to specific structures has been correlated with specific pharyngeal phase swallow impairment. Swallowing function and quality of life have been examined over time, with improvement seen in both. Preventive/prophylactic swallow exercise programs have been encouraging. Chemoradiotherapy effects on voice have been identified in terms of acoustic, aerodynamic, and patient and clinician-rated perception of function. Improvement in voice has also been observed over time after chemoradiotherapy. Voice therapy has been found to have a positive impact on voice and perceptual measures in this population.Summary-Current studies show some improvement in swallow function after swallow and voice therapy in patients treated with chemoradiotherapy. Further, there is a suggestion of improved swallow function with sparing of organs with specific radiotherapy protocols. Future research needs to focus on specific voice and swallow treatment regimens in the head and neck cancer patient treated with chemoradiotherapy, specifically, timing, frequency, duration, and specific treatment types.

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Section: Voice After Primary Chemoradiotherapy: Instrumental and Percmentioning

confidence: 99%

Section: Voice After Primary Chemoradiotherapy: Instrumental and Percmentioning

confidence: 99%

Section: Voice After Primary Chemoradiotherapy: Instrumental and Percmentioning

confidence: 99%

See 1 more Smart Citation

Effects of chemoradiotherapy on voice and swallowing

Lazarus

2009

Current Opinion in Otolaryngology & Head and Neck Surgery

112

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“…[1][2][3][4] These negative changes are noted in the perceptual, acoustic, and aerodynamic measures, as well as the voice-related quality of life of these cancer survivors. [1][2][3][4][5] However, literature on vocal rehabilitation for the head and neck cancer population only focused on the laryngeal cancer survivors. 6,7 Because the radiotherapy field for laryngeal cancer differs for nonlaryngeal head and neck cancers, these studies provided little guidance for vocal rehabilitation for nonlaryngeal head and neck cancer patients.…”

Section: Introductionmentioning

confidence: 99%

“…Vocal impairment following radiation therapy in nonlaryngeal head and neck cancer patients has been widely documented . These negative changes are noted in the perceptual, acoustic, and aerodynamic measures, as well as the voice‐related quality of life of these cancer survivors . However, literature on vocal rehabilitation for the head and neck cancer population only focused on the laryngeal cancer survivors .…”

Section: Introductionmentioning

confidence: 99%

Effects of electrical stimulation on vocal functions in patients with nasopharyngeal carcinoma

et al. 2016

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Objectives/Hypothesis: This study aimed to evaluate the effects of neuromuscular electrical stimulation (NMES) on vocal functions in patients with nasopharyngeal carcinoma following radiation therapy.Study Design: Prospective, randomized controlled trial. Methods: One hundred forty newly treated NPC patients were recruited and randomized into NMES or traditional swallowing exercise (TE) group. Participants received intensive NMES or traditional swallowing therapy and were followed up until 12 months postrandomization. Fifty-seven participants completed the treatment and all of the follow-up assessments. The Voice Handicap Index-30 (VHI-30) was used to measure the vocal functions of the participants.Results: The NMES group showed no significant changes to their vocal functions, whereas the TE group showed a short-term deterioration of voice functions at the 6-month follow-up. VHI-30 scores returned to the baseline level for both groups at the 12-month follow-up.Conclusions: NMES is shown to provide a short-term benefit on vocal functions for NPC patients following radiation therapy.

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